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影响临床精神病高危青年寻求治疗意愿的因素。

Factors impacting intent to seek treatment within youth at clinical high risk for psychosis.

机构信息

Department of Psychology, Northwestern University, Evanston, IL 60208, USA.

Department of Psychology, Northwestern University, Evanston, IL 60208, USA.

出版信息

Schizophr Res. 2024 May;267:273-281. doi: 10.1016/j.schres.2024.03.047. Epub 2024 Apr 6.

Abstract

Existing work indicates that there is unmet need for care in those at clinical high risk (CHR) for psychosis. However, research on the factors that drive treatment seeking behaviors in this population is limited. Further, it is unknown how help-seeking behavior in CHR individuals compares to those seen in mood disorders, who have a higher rate of treatment seeking behavior. Participants (n = 559) completed an assessment of their intent to seek mental health treatment, attenuated psychosis-risk symptoms, and psychiatric symptoms and diagnoses. Participants were divided into CHR (n = 91), Mood Disorders (MD) (n = 72), or Community Controls (CC) groups (n = 396), whose intent to seek treatment was compared. Associations between intent to seek treatment with past treatment, depression, anxiety, positive and negative symptoms, distress from symptoms, intelligence quotient (IQ) estimates, and insight were assessed in CHR individuals. Further, it was assessed how this differs for the MD group. The MD group reported higher intent to seek treatment than CHR individuals, which reported higher intent to seek treatment than the CC group. In those at CHR, previous treatment, greater depression and anxiety severity, and higher distress all independently predicted higher intent to seek treatment. Depression predicted intent to seek treatment in both MD and CHR individuals. Previous treatment predicted intent to seek treatment in those at CHR. Our findings suggest that depression and past treatment utilization are critical factors in increasing intent to seek treatment in those at CHR, potentially serving as important targets for engaging this population in treatment.

摘要

现有研究表明,处于精神病临床高风险(CHR)的人群存在着未满足的治疗需求。然而,针对该人群中驱动治疗寻求行为的因素的研究却很有限。此外,尚不清楚 CHR 个体的求治行为与心境障碍个体的求治行为有何不同,后者的求治行为率更高。研究纳入了 559 名参与者,对他们寻求心理健康治疗的意愿、减轻的精神病风险症状以及精神科症状和诊断进行了评估。参与者被分为 CHR 组(n=91)、心境障碍组(MD)(n=72)或社区对照组(CC)(n=396),并对三组参与者的求治意愿进行了比较。在 CHR 个体中,评估了与求治意愿相关的因素,包括过去的治疗、抑郁、焦虑、阳性和阴性症状、症状困扰、智商(IQ)估计值和洞察力。此外,还评估了这与 MD 组的差异。MD 组报告的求治意愿高于 CHR 组,而 CHR 组报告的求治意愿又高于 CC 组。在 CHR 个体中,过去的治疗、更严重的抑郁和焦虑以及更高的困扰程度均独立预测更高的求治意愿。抑郁预测了 MD 和 CHR 个体的求治意愿。过去的治疗预测了 CHR 个体的求治意愿。研究结果表明,抑郁和过去的治疗利用是增加 CHR 个体求治意愿的关键因素,这可能是促使该人群接受治疗的重要目标。

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